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<br />'-'''''\''';'"lW"'_~-~-'''?->'',__"",~,~,_1<' -:':"~"""'.~"1"'!l'i ";':',::"~', <br /> <br />APPLICAnON FOR PERKIT <br />CITY OF ZEPIIYRBILLS <br />BUILDING DEPAR'l'HERT <br /> <br />OWNER'S IIAKE 57: ';;'5~kJ.# /A:r/I~t/b .t?Rv/?~I-I PHONE 782-'" 7S/? <br />OWER'S ADDRESS '3 f> t\f I? h ?,# ;:1 n~ :;;2 - .dA ~ <br />JOBADIlRESS -:3'87lP 2rHH""'L/ ~~/?,//O{SftJFE'/ <br />LEGAL DESCRIPTION: LOT(S) _ BLOClL--SUBDIVISION <br /> <br />PARCEL I. D. 1 (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:__ew Coostruction ---..Addition ~eration ----Repair _Install <br /> <br />_Sign <br /> <br />--.Jfove <br /> <br />->>eaolish <br /> <br />PlIOPOS1lIl lISE: Z" F-UY <br />ec:-ercial <br /> <br />--.J{/F _' of Units ----3t/H <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />__estaurant Ii Health Departaent Approval <br />DESCRIPTIOR OF WORK: / 11/~ i0~j 7/A/O /P.l.fs.T AaJh?, 5' <br /> <br />BUILDDG SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMKERCIAL : <br /> <br />ATTACH (2) PLOT PI.ARS Ii (2) SETS OF BUILDING PLARS Ii (1) SET ENERGY FORMS. <br />ArrACH (3) SETS OF BUILDDG PLARS Ii (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CORSTRUcnON. <br /> <br />PERMITS REQUESTED <br /> <br />~UILDDG <br /> <br />$ <br /> <br />1/ 57/)/ &;0 <br /> <br />Valuation of Total Construction <br /> <br />Rl.RC!'lUCAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />--Z:CAL <br />~DG <br /> <br />$ <br /> <br />Valuation of lIecbanica1 Installation <br /> <br />GAS <br /> <br />ROOFIRG <br /> <br />SPECIALTY <br /> <br />TYPE 9F COIISTlWCl'IOR: ~loclt _Fraae _Steel <br /> <br />Other <br /> <br />PDIISIIBD FLOOR. BLEVAnORS: <br /> <br />FT. <br /> <br />IS PROJECT D FLOOD ZOO AREA? <br /> <br />~. <br />YES NO <br /> <br />****************************************** <br /> <br />CORTRACTOR SECTION <br /> <br />BIJTI.Da Q)l(pAIIY <br />State Cert. or Regist. 1 <br />Signature City License Registration 1 <br />****************************************** <br /> <br />Rl.RCTRICIAR COMPANY <br />State Cert. or Regist. 1 <br />Sianature City License Registration 1 <br />****************************************** <br /> <br />PLOKBER COHPANY ~ ?J' I <br />State Cert. or Regi 1 <br />Signature City License Registration 1 <br />****************************************** <br /> <br /> <br />IlEClWiICAL COMPANY <br />State Cert. or Regist. 1 <br />Sigoature City License Registration . <br />****************************************** <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. . <br />Sigoature City License Registration 1 <br />****************************************** <br /> <br />APPLICAnOR APPROVED BY PERKIT OFFICER. <br />